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About 90% of the people in the world have some form of Periodontal Disease or Gum Disease. Gum Disease is a complex inflammatory disease caused by bacteria in susceptible patients and is known to affect at least 100 million people in this country alone.
Most Gum Diseases are long standing, slowly progressing problems that are caused by bacteria in plaque. Plaque is a thin biofilm or sticky film-like substance that forms on your teeth. If your home care is sloppy or you skip dental visits, plaque builds up on the teeth. This biofilm is an irritant and your body responds to this by producing chemicals. These chemicals inflame and damage the gums and/or the supporting structures. As plaque builds up, it gets hardened up with the salts in your saliva to become Tartar or Calculus. Tartar is quite adherent and brushing alone cannot dislodge it. Tartar is also very rough and gnarly with lot more hiding places for bacteria to grow.
As the disease progresses there is more inflammation leading to swelling of the gums and loss of the ligaments that anchor your gums to the tooth. Think of your gums like a turtleneck sweater. It's supposed to be snug against the neck or in this case the neck of the tooth. As the gums swell, they detach from the tooth resulting in a sloppy gums that make teeth sensitive. They also result in deep spaces around the teeth called “pockets’. The spread of disease speeds up now because toothbrush cannot clean under the gums and there is now a safe haven for bacteria to thrive. This encourages further plaque buildup, causing the problem to snowball.
Untreated gum disease will present in different ways. Sometimes it's bad breath that won’t go away, other times its red or swollen or tender gums, receding gums etc. Other times they present as “tooth problems” and not gum problems. Teeth that are in the infected areas will be painful to chewing, feel loose or sensitive. Other times teeth can get flared out with gaps forming in between them.
So...to summarize, gum diseases can be classified into many types but for our discussion there are two main types. There is inflammation that stops in the gums or gingiva called gingivitis. This is the milder form of the disease where the underlying supporting structures are not involved yet. This is a reversible condition and in most cases painless. Long standing gingivitis will eventually result in inflammation settling into the deeper areas of the gum tissues like the Periodontal ligaments or the Alveolar bone. Periodontal ligaments are shock absorbers that form a sheath surrounding your teeth. The Alveolar bone is the bony housing that your teeth are set in. Once disease spreads to these deeper areas it is then called Periodontitis. The damage caused by Periodontitis is usually not reversible and a difficult condition to manage.
Gum disease does affect your overall well being. There is growing but inconclusive research that supports gum disease being associated with adverse pregnancy outcomes, cardiovascular disease, stroke, pulmonary disease, and diabetes. A lot of these conditions are occur together but its not clear if gum disease can cause these problems by themselves. Smokers also have a hard time with gum disease. Some people are genetically prone to getting gum disease.
So now that we recognize that gum disease is a important problem, we want to stress that prevention is the best treatment for this disease. Even though clinical dentistry has come a long way, we still do not have a predictable way to regain lost bone and gum tissue once the disease has set in. So prevention, prevention, prevention.
Tooth brushing and other measures by which the teeth are mechanically cleaned remain the most effective way to control plaque accumulation and periodontal disease. Flossing to clean in between teeth is very important. Waterpik might be a good aid for some patients. Mouthwash is a good aid but cannot be the main way to clean teeth.
It is also very important to visit your dentist regularly. Most people should see the dentist once every six months. Professional cleanings by your Dental Team will keep bacterial build up under check as there will be areas where a toothbrush and/or floss cannot reach.
When you visit our office-Pearl Family Dental, to get screened for gum disease we will assess the severity of the problem. If you are like most patients with inflammation in the gums or gingivitis then a simple cleaning or “Oral Prophylaxis” will suffice. However if the inflammation has spread to the deep areas then a “Deep Cleaning” or “Scaling and Root Planing” procedure might be required. In other patients with advanced gum disease, more aggressive treatments involving surgery and bone grafting might be indicated. Patients who have had “Deep Cleaning” done in the past may be seeing their Dentist sooner than 6 months as they are more susceptible to tartar build up.
Again, we cannot stress this enough. Prevention is the best game in town for this disease. If your are looking for a dentist near you/ in Fredericksburg area or you need to get a free consult or have any questions about Dry Mouth call our office at 540 370 8504 or email us at smile@pearlfamilydental.com.